@johnnyz
I had 5 sessions of sbrt in Dec. '25 over 2 weeks) and 120 days of orgovyx (ending in March '26). The fiducial markers are, I am advised, very accurate in preventing urethral damage and nerve damage. The barigel spacer (rectal spacer) is, again, as I am advised, very accurate. 6 months post treatment zero side effects at this point. Intimacy is not a struggle, some mild urgency to pee, no bowel issues - to date. My diagnosis: 2 tumors gleason 7 (3+4) with cribriform and 4 tumors gleason 6. I am 64 - retired, very active, no other health concerns.
I was advised by Dr. Joseph Wagner (Hartford Tallwood Mens Health) that surgery vs. SBRT were equipoise - 3 second opinions (MSK, Smilo, Tufts) with surgeons and radiologists confirmed the same. Both treatments work and are curative in intent. Side effects included some discomfort near the end of radiation and some fatigue and hot flashes from orgovyx - all 100% manageable. This site has many helpful members that helped me a lot (Jeff Marci key among them and Heavy Phil etc) and their recommendations - exercise particularly - was very helpful- lots of good information across the site. Also, Mark Scholz (youtube) was very influential and I recommend watching his presentations. Exercise was Very Helpful for me. Good luck with your decision - there are no wrong decisions - only the one that works for you and that will be the right option.